Tag: molecular biology

While I have been working in the field of all things “Molecular” for close to twelve years, it wasn’t until early this year that I decided to actually sit for the ASCP certification exam in Molecular Biology. With over five years working in research and currently going on seven years in a clinical lab, I was feeling pretty confident about my knowledge and background, but then panic set in. Would I be able to pass a test? I haven’t taken an exam since my final years of college! I have two young children who are extremely active in extracurricular activities, a husband who also works full time. Needless to say, any extra time I had for myself would be spent studying. It didn’t take long to find out that while there was a very general outline of topics covered and an extensive list of textbooks to serve as a starting point, there were not specific details on where to focus my efforts. There was no single study guide, no tangible tools I could utilize to make exam preparation fit into my busy life any easier.

Fast forward to the present, where all of the panic was for not. In February I did pass (with flying colors) and happily sport MB (ASCP)CM after my name. When I was recently approached about writing on a regular basis for Lablogatory, I knew it would be an amazing opportunity to educate others on the exciting field of Molecular Diagnostics as well as combat the fear that comes with taking the Molecular Biology exam. I plan to focus on more specific areas in the field of Molecular Diagnostics that I came across in my studies, which will help others in their preparation for the MB(ASCP) exam. I will cover theory, applications, techniques, and practices. Also, keep an eye out for case study questions that I will provide to stretch your thinking through interpretation of molecular results, at the same time, keeping you up to date on hot topics in the field.

With all that said, the first most important suggestion I have is: spend time preparing to study. While it might seem silly to some, having a plan BEFORE you jump into study mode will actually set you up for success. All too often, just reading everything you can on every single topic will result in information overload and ultimately burn you out. You will quickly find yourself jumping all over the place frantically trying to memorize every detail you come across.

First, browse the content outline and choose some texts to review. Notice how I say, “Choose some?” Don’t feel like you have to read all of them. I went online and reviewed the texts, I asked colleagues for recommendations, then decided to purchase two books. You might find that you need more or less, just don’t go overboard.

Next organize a binder. I am extremely visual and hands on so I study best with things in front of me that aren’t electronic based. I divided my binder based on the content outline. You will come across papers, technical notes, and procedures that you will want to keep as study tools. Having a binder for all of these notes from multiple sources will keep you on track. It will also serve as a great reference guide for you as you move through your career.

Now is where you can get super retro. You may have noticed in my photos that I made flash cards! It is a little archaic and time consuming, but I knew I was going to be busy with my daughter’s traveling basketball team; therefore, I needed something small I could take with me to study while sitting on the bleachers. I am aware of software programs that allow you to make electronic based flash cards, so if that works better for you feel free to try that route.

My take home message is, obtain and prepare whatever tools you need to get yourself ready to study. Organization is key and setting aside time each day, even if only an hour to focus on one application or theory will definitely be to your benefit. Reach out to colleagues and gather as much information as you can. Once all of your tools are in place, it’s time to get to work! For anyone interested in obtaining their MB(ASCP) certification, I urge you to check out the content outline and list of texts on the ASCP Board of Certification site.

-LeAnne Noll, BS, MB(ASCP)CM is a molecular technologist at Children’s Hospital of Wisconsin and was recognized as one of ASCP’s Top Five from the 40 Under Forty Program in 2015.

An FDA panel recently recommended use of Roche’s Cobas HPV DNA test as the initial screening tool for cervical cancer instead of the ubiquitous Pap smear. The panel found that “A negative HPV result predicted a lower 3-year risk of ≥CIN3 than did a negative cytology result, suggesting that using HPV as the primary test is superior to cytology for cervical cancer screening.The low 3-year CIR for a negative HPV result also confirmed the safety of a 3-year interval for HPV primary screening and officer clinicians more confiedence in a negative HPV result than a negative cytology result.”

While this isn’t a final FDA guideline, it’s conceivable that clinicians could alter their practice based on these findings. Of course, this will affect the cytology and molecular diagnostics departments, as well. What do you think? Is HPV viral testing the way to go? Or should we stick with the test that’s been around for decades?

I was reading about the FDA’s recent crackdown on 23andme to stop marketing their saliva based whole genome testing and interpretation service. Rather than resist, 23andme decided to comply and is currently in “talks” with the FDA so that they can complete the process for FDA validation and again begin to market their kits and testing. For now, they can continue to provide their genealogy testing and whole genome sequencing without interpretations.

Currently, in some academic research centers, whole genome or exome sequencing via next generation sequencing (NGS) methods is utilized on a limited basis by researchers and clinicians to identify pathogenic mutations. NGS and bioinformatic analysis methods continue to steadily improve and costs have been decreasing. However, there are limitations and barriers to widespread use at this point. These include but are not limited to: 1) widely used databases such as the Human Gene Mutation Database (HGMD) and the Online Mendelian Inheritance in Man (OMIM) still only contain information that only covers a fraction of the human genome, 2) more research is still needed to identify more variants mutation-disease associations, and 3) most mutations identified fall under the category of “unknown clinical significance”.

Tools such as NGS, despite its improvement over previous technology, still cannot identify large deletions or copy number variations (CNV) and is a technology not accessible, cost-wise and support-wise, to most health care institutions. Despite all of this, primary care physicians, even now, still may be confronted with patients who bring them their genomic screening results, whether obtained from commercial services provided by companies like 23andme or through molecular testing through a health care institution. But today’s physicians, including primary care physicians and pathologists, were not trained in medical school to understand how this testing is performed or the significance of these results. But the time is coming, and maybe sooner than we realize, when we will have to deal with such testing on a daily basis.

So, it is imperative that we train our doctors and doctors-in-training now to be ready for when that time comes. But, my question this week is “How should we go about it?” Additionally, who should compose the health care team to provide guidance and counseling to patients once results are available? And who should regulate how testing should be done and what information should be included in results reporting? Leave me a comment if you have an opinion or any ideas.

–Betty Chung, DO, MPH, MAis a second year resident physician at the University of Illinois Hospital and Health Sciences System in Chicago, IL.